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About miscarriage

Miscarriage is when a fetus stops growing and dies before 20 weeks of pregnancy. In Australia, if it isn’t clear how far along a pregnancy is, doctors will call it a miscarriage if the fetus weighs less than 400 gm.

Miscarriages are very common and happen in about 1 in 5 confirmed pregnancies, usually in the first 12 weeks. Miscarriage can happen before you or your partner know about the pregnancy.

Anyone can have a miscarriage. Miscarriage happens for many different reasons. Once a miscarriage begins, no medical treatment can stop it.

In Australia, miscarriage means that a pregnancy has ended before 20 weeks. Pregnancy loss after 20 weeks is referred to as stillbirth.

Symptoms of miscarriage

Miscarriage can happen suddenly or over a few days or weeks, and symptoms can vary.

Vaginal bleeding is the most common symptom of miscarriage. The bleeding can be light or heavy. There might also be blood clots.

Other symptoms might include lower stomach cramps, similar to period pain. Or you might notice that there are no longer signs of pregnancy, like sore breasts, nausea or vomiting.

There’s nothing you, your partner or a midwife or doctor can do once a miscarriage has begun. But if you or your partner think a miscarriage is happening, it’s essential to call a midwife or doctor.

A miscarriage is usually confirmed when an ultrasound scan can no longer detect a baby’s heartbeat.

Vaginal bleeding during pregnancy doesn’t always mean that a miscarriage is happening. But it does need medical attention, so see a midwife or doctor straight away. The midwife or doctor can check whether the pregnancy is still progressing as expected.

After a miscarriage: what to expect

Pregnancy tissue often passes naturally on its own within a few days, but it might take up to 2 weeks. While this is happening, there might be heavier bleeding and period cramps.

Use sanitary pads rather than tampons to manage the bleeding in the first few days after a miscarriage. This helps to prevent infection.

Paracetamol or ibuprofen can help with pain management.

Sometimes medicine or a dilatation and curettage (D&C) can help the pregnancy tissue pass more quickly. A D&C is a surgical procedure that gently scrapes away any tissue still lining the uterus after a miscarriage.

The midwife or doctor can help you decide on the safest and best option.

Complications after miscarriage

Sometimes there can be complications after a miscarriage, like ongoing bleeding or infection. These complications are rare and might happen when the pregnancy tissue doesn’t pass on its own.

Here’s when to see a doctor immediately:

  • The bleeding gets heavier.
  • There’s a lot of pain or the pain gets worse.
  • There are signs of an infection – for example, a bad smell from the vaginal bleeding, fever or nausea.

If there are complications, midwives and doctors might suggest medicine or a D&C.

It’s important to see a midwife or GP if pregnancy tissue hasn’t passed 2 weeks after a confirmed miscarriage. Often the tissue passes as part of normal bleeding, so it might not be noticeable. You can assume the tissue has passed if the bleeding has settled.

Feelings after miscarriage

There’s no right way to feel or grieve after a miscarriage. Everyone grieves in their own way and time.

A miscarriage can bring up intense feelings of grief, emptiness, sadness, anger, anxiety and depression. A miscarriage can be shocking and devastating for you and your partner. You’ve lost not only a pregnancy but also your hopes and dreams of becoming a parent or of having another child.

Many people want answers about how and why the miscarriage happened. It’s hard, because often there’s no clear reason for the miscarriage.

Experiences of grief after miscarriage: partners

You and your partner might experience or express grief differently.

For example, some people might find it hard to say how they feel but might exercise or work more as a way of letting out their grief. Some people might not like talking about the miscarriage with others. And sometimes the partners of women who’ve had miscarriages might feel that their feelings aren’t important.

It’s normal to have different feelings, and the feelings of both partners are important.

If you and your partner can share your feelings and talk openly after the miscarriage, it can help you both through this difficult time.

Both you and your partner need time and support after a miscarriage. Try to make time to do things you both enjoy or find relaxing or rewarding. This is good for your relationship and good for you as individuals.

Sharing your grief about miscarriage with others

It can be difficult and upsetting to tell family and friends about the miscarriage and your grief. It can be even harder if you hadn’t yet told people about the pregnancy.

Not everyone will understand your need to acknowledge and grieve the loss of your pregnancy. Some people might even try to comfort you by saying things that minimise your loss. For example, ‘At least you know you can get pregnant’ or ‘At least you have your other children’.

But many people find that it does help to tell others. You could let close friends and family know what the pregnancy meant to you, what support you need, and how much you want to share your experience.

If you don’t feel like talking about your miscarriage, you could keep a journal of your thoughts, feelings and memories. Or you might like to apply for an early pregnancy loss commemorative certificate.

Getting help with grief after miscarriage

It’s likely that your grief will pass with time and support from friends and family. But if you feel you aren’t coping, you might need professional help. See your GP, a counsellor or a community spiritual leader, if you have one.

Here are more ways to get support:

  • Call Red Nose Grief and Loss on 1300 308 307.
  • Go to The Pink Elephants Support Network – Find support.
  • Call Bears of Hope on 1300 114 673.
  • Contact Sands – Fathers support services.
  • Call MensLine Australia on 1300 789 978.
  • Lifeline on 131 114.

Getting pregnant again after miscarriage

The decision to try for another pregnancy is up to you and your partner. You can both decide when the time is right.

You or your partner might be keen to start trying to get pregnant again. You might also feel pressure from family, friends or colleagues about trying for another baby.

But it takes time to recover emotionally from a miscarriage. If you were pregnant, you’ll need time to recover physically from the miscarriage.

If you have any concerns, it’s best to talk with your doctor about the right time, both physically and emotionally.

Causes of miscarriage

Miscarriage is common and happens for many different reasons. But it’s often hard to say exactly what has caused a miscarriage.

Miscarriages can be caused by chromosomal or heart anomalies that stop the embryo or fetus from developing properly. Sometimes the embryo doesn’t divide properly at the time of fertilisation. Miscarriages are also more common in older pregnant women.

Smoking, drinking alcohol, taking illicit drugs, and having high levels of caffeine are risk factors for people’s general health They’re also possible risk factors for miscarriage. If you avoid these things before and during pregnancy, it will give your baby the best chance of a healthy start to life.

Some couples experience multiple miscarriages. In these cases, an obstetrician might be able to offer some tests to try to find a cause.

Translations: Arabic

With permission, this article has been culturally adapted, modified and translated into Arabic by Raising Children Network community partner, Rahma Health. To read this article in Arabic, go to Rahma Health – Miscarriage: what it is and how to cope.

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Raising Children Network is supported by the Australian Government. Member organisations are the Parenting Research Centre and the Murdoch Childrens Research Institute with The Royal Children’s Hospital Centre for Community Child Health.

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